| NPI | 1043481831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS JOHN STICH Administrator 716-433-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 500-F-093) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |